Individual
ALEKSANDRA OLSSON-DETWILER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1000 S BECKHAM AVE, TYLER, TX 75701-1908
(903) 521-7838
(903) 566-3297
Mailing address
PO BOX 132601, TYLER, TX 75713-2601
(903) 521-7838
(903) 566-3297
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
L1685
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
167741101
—
TX
01
—
8P9640
BCBS
TX
01
—
P00151113
RAILROAD MEDICARE
TX
Enumeration date
07/22/2005
Last updated
06/23/2008
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